Nursing: Unit Closures and Restructuring

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Introduction

Unit closures and restructuring greatly impact the quality of health care provided and should be addressed professionally. It refers to the segmentation of assets or function of the nursing team into a separate corporation. Unit closure involves reducing the number of nurses in a department or transferring nurses to various departments. To contain the rapidly rising health care cost, many hospitals have taken the initiative to cut costs by employing fewer and less-experienced nurses or working them long hours. This may compromise the quality of health care provided and only need professional standards employed to address the issue. Nursing leaders and managers play critical roles in unit closers and have different approaches to addressing the issue while maintaining quality nursing practices.

Role of nursing leaders and managers

In recent years, nursing unit structuring and closures have taken place in most countries. The occurrence of unit closure leads to severe stress and impacts the quality of care and patient safety when not well addressed. Nursing leaders and managers employ theories, principles, and skills to ensure that the action is done without affecting the quality of health care provided (Maciel et al., 2021). Unit closures and restructuring affect nurses at the forefront in providing health care services. If a nursing facility has a pending unit closure, the nurses have much work, which causes pressure and distress. The nurses may become unsatisfied with their jobs due to problems of job insecurities. A considerable workload may also cause stress and depression in nurses and can destroy their motivation in the workplace. Patients who might not be aware of the situation of the nurses may be affected, and their condition may worsen. Therefore, there needs to be professionalism in handling unit closures and restructuring.

Unit closures and restructuring are sensitive and should be done according to professional standards. Research has it that nurses perform according to their job satisfaction, and problems such as distress at work should not be tolerated in nursing practice. During the closure of a unit, the nurse is moved to a new environment, and this movement might come with anxiety (Kirk, 2020). Even though adapting to a new environment may not be a problem for nurses, this movement might affect a nurse’s job satisfaction. The nurse might become frustrated and may think of losing the job shortly. This dramatically affects the quality of care and patient safety, the nurse’s sole responsibility. The transfer can be minimized by cross-training to make nurses less anxious. The management can employ travel nurses who seem to be more conversant with the working in different environments and who are not affected by anxiety. Travel nurses play critical roles in ensuring that health care quality is not compromised during unit closure and restructuring practices.

Nursing leaders and managers play a critical role in ensuring high-quality patient health care is provided. However, they have different approaches to the issue of unit closure and restructuring. Nursing leaders are responsible for overseeing hiring, staffing, and performance in a nursing unit. They assist and support nurses from the front and are passionate about nursing, acting as role models and mentors to junior nurses. They help in managing conflicts and quickly develop personal staff connections. On the other hand, nursing managers are responsible for the day-to-day operations in the unit. They are primarily concerned with communication and are focused on ensuring that the patients receive the health care required. The managers are responsible for hiring nursing staff and reviewing the performance of the nurses. Nursing management relies on leadership skills; however, nursing managers work with nursing teams to implement incentives introduced by the nursing leaders (Weiss et al., 2019). The approaches by managers and leaders in the nursing unit differ because of the differences in perceptions towards work.

The nursing leaders and managers are responsible for ensuring that quality care and patient safety are not affected by unit closures and restructuring. Nursing leaders should ensure that the operations move smoothly and that unit closure and restructuring do not alter the unit’s day-to-day operations (Maciel et al., 2021). To do this, the managers need to investigate any problems, set goals, and plan operations for the nursing team. Generally, managers work at achieving goals and objectives, which explains why they need to be good at decision making with proper communication skills. On the other hand, nursing leaders are responsible for treating everyone equally during unit closures. Their leadership quality means that they can attend to every individual equally and on personal requests and circumstances. Unit closure and restructuring affect nurses in various ways; therefore, nursing leaders have the responsibility to help these nurses transit successfully and cope with the situation. They work to ensure that individual nurses grow to become professionals in the medical field through mentorship and coaching practices built from personal relationships.

Nursing leaders and managers need to be so flexible to address the issues at hand. Unit closures and restructuring pose significant challenges, and leaders and managers should adjust quickly to curb these challenges (Maciel et al., 2021). Therefore, nursing managers and leaders need to understand the various theories that deal with similar issues. One such theory is the transformation leadership theory which encourages the empowerment of junior employees for long-term success. The approach focuses on long terms goals and the importance of empowering others. When addressing the issue of unit closure and restructuring, the nursing leadership and management should practice a high level of professionalism. The professional boundaries should be drawn for both leaders and managers and roles should be defined for every individual. There should be no conflict in managing and leading teams during unit closure and restructuring (Kirk, 2020). Nursing managers should improve employee performance by conducting reviews while leaders work to encourage and support the nursing team in achieving their goals.

Various leadership styles can best solve issues in a nursing unit. However, the participative leadership style comes out as the best to employ when addressing the problem of unit closures and restructuring (Kirk, 2020). This style ensures that everyone is involved in the decision-making process. When nursing leaders involve junior nurses in decision-making, the employees get a sense of belonging and are determined to solve problems on behalf of the organization. Unit closure and restructuring affect people individually; therefore, involving individuals in making decisions allows them to mention how they feel about the situation to arrive at a solution.

Conclusion

In conclusion, unit closures and restructuring in nursing significantly impact health care quality and patient safety. The nursing managers and leaders both have a role to play in ensuring that the quality of health care is not compromised during unit closures and restructuring. Even though the nursing leaders and managers have different roles and approaches to solving the issue of unit closures, they play a big part in making sure the problem does not get out of hand. The effects of unit closures and restructuring need combined efforts to address. Therefore, a participative leadership style should be employed by the relevant stakeholders.

References

Kirk, M. E. (2020). When it is no longer your call: managing the eroding public health nurse role (Doctoral dissertation).

Maciel, D. P., Giannini, R., Sá, E. C., & Sznelwar, L. I. (2021). Impacts of organizational restructuring on the health of ambulance drivers from a university hospital. Ciencia & saude coletiva, 26, 5935-5944.

Weiss, S. A., Tappen, R. M., & Grimley, K. (2019). Essentials of nursing leadership & management. FA Davis.

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